创伤性后颅窝血肿的临床治疗分析

Analysis on clinical treatment of traumatic hematoma in posterior fossa

目的：探讨创伤性后颅窝血肿的临床治疗方法，提高临床治疗水平。方法对我院2008-02-2013-05收治73例创伤性后颅窝血肿患者的临床资料进行回顾性分析，总结临床治疗方法。结果本组73例患者均行手术治疗，根据术前C T检查确定血肿位置施行开颅血肿清除术，手术均成功，一次性清除成功率为95.8％。术后3～17 d死亡5例，1例系呼吸功能衰竭，2例系术后脑干损伤引起功能衰竭，2例系心肺功能衰竭。本组患者病死率为6.8％。对所有患者进行为期6个月的随访观察，应用GCS评分进行评价恢复情况，结果恢复良好49例，伤残17例，植物生存2例，死亡5例。结论创伤性后颅窝血肿临床致残率、致死率较高，根据患者病情及血肿特点进行早期诊断、早期手术治疗十分重要，对改善患者预后具有重要意义。

Objective To explore the clinical treatment method of traumatic hematoma in posterior fossa ,and to improve the level of clinical treatment.Methods The clinical data of 73 cases with traumatic hematoma in the posterior fossa treated in our hospital from February 2008 to May 2013 were analyzed retrospectively ,and the clinical treatment methods were ana-lyzed.Results 73 patients received surgical treatment ,and all patients received craniotomy stereotactic therapy by determining hematoma location according to CT examination before operation ,and all operations were successful. The successful rate of one-time clearance was 95.8%. There were 5 dead cases 3~17d after operation ,among them ,1 case with respiratory failure , 2 cases with function failure caused by brain-stem injury and 2 cases with cardio-pulmonary function failure. The death rate of the patients was 6.8%. All patients were followed up for 6 months ,and the recovery was evaluated by GCS score. After treat-ment ,there were 49 cases with good recovery ,17 cases with disability ,2 cases with vegetative state and 5 dead ca-ses.Conclusion The clinical disability rate and fatality rate of traumatic hematoma in posterior fossa are high. Early diagnosis and early surgical treatment according to the condition of patients and the characteristics of the hematoma are very important , which has great significance to improve the prognosis of patients.